This year, the Annual Meeting of the American Society of Clinical Oncology (ASCO) did not produce any truly groundbreaking revelations about new treatments for lung cancer. However, researchers did report quite a few positive findings, and some disappointing ones. I have summarized some of the more prominent presentations below. Continue reading…

The UK’s National Institute for Health and Clinical Excellence (NICE) has released a guidance document specifying which tests it recommends for detecting mutations of the EGFR gene in non-small cell lung cancer (NSCLC) patients. Patients with EGFR mutations usually benefit more from treatment with EGFR inhibitors rather than traditional chemotherapy, while these drugs are less effective in patients without such mutations. Accurate detection of EGFR mutations is therefore very important. NICE recommends the therascreen EGFR RGQ PCR Kit, the cobas EGFR mutation test, Sanger sequencing of samples, or combined approaches that use Sanger sequencing for samples with more than 30% tumor cells, and one of the two other tests for samples with lower tumor cell density.

The FDA has approved the use of erlotinib (Tarceva) as a first-line treatment for patients with advanced non-small cell lung cancer (NSCLC) who have a mutation in the EGFR gene. Tarceva, a tyrosine kinase inhibitor (TKI) that inhibits EGFR, had already been approved for patients with advanced NSCLC as a second- or later-line treatment if at least one chemotherapy regimen had failed, or as maintenance treatment if their disease had not progressed after four cycles of chemotherapy. At the same time, the FDA approved, for the first time, a test for EGFR mutations, the cobas EGFR Mutation test. The test enables doctors to identify which patients have EGFR mutations and are therefore candidates for first-line treatment with Tarceva, making it a so-called ‘companion diagnostic’ for Tarceva.

Testing for EGFR gene mutations in non-small cell lung cancer (NSCLC) helps identify patients who could benefit from treatment with EGFR-tyrosine kinase inhibitors (TKIs) like erlotinib (Tarceva), gefitinib (Iressa), or afatinib. However, there are no official recommendations for specific EGFR mutation tests. A study comparing three tests—cobas EGFR Mutation Test, Therascreen EGFR29 Mutation Kit, and 2× bidirectional Sanger sequencing—found that the cobas and Therascreen tests were more accurate and sensitive than Sanger sequencing. The cobas test required the smallest amount of tumor tissue, while the Sanger test can theoretically detect more types of mutations than the other tests.